[Pre-neoplastic bronchial lesions: possibilities of diagnosis and chemo-prevention]

Early diagnosis of pulmonary cancer is crucial in the fight against this disease. Pre-neoplastic bronchial lesions are the first stage in the evolution towards invasive cancers. This paper describes histological patterns of these pre-neoplastic bronchial lesions, as well as early, intermediate and late molecular disturbances associated with this condition. The ways to early identification of these lesions are: a) bronchoscopy with laser-induced auto-fluorescence guided through Optical Coherence Tomography, which is able to identify cellular and extracellular structures, from the cellular surface or beneath it; b) PET-CT which identifies lesions over 6 mm; c) bio-markers: the sensitivity of the test is 60-70%; the positive predictive value is higher when these markers are taken together. p53 and p16-INK4A genes seem to have the higher predictive value. Identification of these disturbances leads to improved possibilities of chemo-prevention.